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Posted by john on July 2nd, 2007 — in Nexium Top News
LONDON (Thomson Financial) - Leading shares remained lower at midday with Wall Street seen opening higher as investors braced themselves for a further Bank of England rate hike later this week.
At 11.55 am, the FTSE 100 index was 16.8 points lower at 6,591.7, recovering slightly from the session low of 6,570.5, while the FTSE 250 index also slipped 31.8 points to 11,495.8.
Volume was fair, with 808.7 mln shares changing hands in 191,915 deals.
‘The market is quite volatile at the moment, but the key event is the BoE interest rate decision with the market expecting rates to be raised by a quarter of a point,’ said Keith Bowman, UK equity analyst at Hargreaves Lansdown.
‘On a wider base, the market is also caught between the start of the US second earnings season, which is providing some support for the market, offset by concerns of a credit crunch and rising bond yields,’ added Bowman.
In the US, Wall Street is looking at a mostly higher open, supported by merger and acquisition activity, but firm crude oil prices and heightened terrorism fears are likely to keep a cap on gains.
According to spread bettors IG Index, the Dow Jones Industrial Average is expected to open up around 20 points at 13,429. Separately, S&P 500 futures rose 2.90 points to 1,518.30, while Nasdaq 100 futures dipped 0.25 points to 1,955.75.
In US economic news, investors will receive a snapshot on the state of the nation’s manufacturing sector with the monthly report from the Institute for Supply Management.
The ISM’s closely-watched index is expected to to tick up to 55.4 from 55, suggesting the sector is continuing to expand.
On the blue chip downside, British Airways slipped 2.03 pct or 8-1/2 pence to 410 following Saturday’s failed terrorist attack at Glasgow airport that resulted in severe disruption to services.
The rise in oil prices on Friday was also weighing on the stock.
Elsewhere, fading bid hopes for its US beverage unit and some profit-taking knocked 14-1/2 pence off Cadbury Schweppes’ share price to 665-1/2.
And turning to the pub sector, following yesterday’s start of England’s smoking ban, shares in Mitchells & Butlers were 14-1/2 pence lower at 865, while Enterprise Inns shares lost 15-1/2 pence to 673-1/2.
On the upside, oil producers moved up after prices settled above the psychologically important 70 usd per barrel mark on Friday for the first time since Aug 2006 on worries about gasoline supplies in the heart of the summer driving season.
BG moved up 9-1/2 pence to 831, Royal Dutch Shell ticked up 24 pence to 2,107 and BP added 2 pence to 605-1/2.
Meanwhile, Astrazeneca edged up 11 at 2,694 after Deutsche Bank resumed coverage with a ‘buy’ stance and price target of 3,200 pence following the group’s change in EPS guidance.
Deutsche Bank said it believes the switch to cash EPS by Astrazenca outweighs recent weakness following a slowing in its Crestor/Nexium pharmaceutical products.
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On the second rung, PartyGaming led the mid-cap risers up 2-1/4 or 7.32 pct at 33 after the world’s biggest online gambling firm said its financial performance in the second quarter was in line with management expectations, adding it remains confident about its full-year prospects.
Numis said it has upgraded its recommendation on the stock to ‘buy’ from ‘hold’ given the recent share price weakness.
Also in earnings news, builder Galliford Try moved 9-1/2 pence higher to 168-1/4 after issuing a strong full-year trading statement in which it said trading had been strong across all divisions.
In reaction, KBC Peel Hunt raised its estimates and Altium Securities to retain its ‘buy’ rating on the group.
Shares in William Hill were also higher, up 6-1/2 pence to 621-1/2, after the UK bookmaker said it continues to trade in line with management expectations and expects to report earnings before interest and tax for the first half of 2007 marginally ahead of last year.
On the downside in the midcaps, the travel and tourism sector was lower after the market took a cautious view on the sector following the failed UK bomb attacks and a cautious note by Credit Suisse on Thomas Cook.
Shares in Thomas Cook fell 11 at 313 while peer First Choice Holidays was 11 lower at 308.
David Pope, analyst at Brewin Dolphin, said: ‘The market is taking a negative view following the failed attempted UK bombings. Although it is unlikely people will stop going on holidays as a result of the failed attacks, the market has taken a cautious view in anticipation.’
‘There has also been negative broker comment regarding peer Thomas Cook, and First Choice Holidays is likely to have gone down in sympathy,’ added Pope.
Credit Suisse initiated Thomas Cook this morning with an ‘underperform’ stance and a price target of 255 pence.
The broker added it is taking a negative view on the package-holiday market, which is at the core of the group’s operations.
Elsewhere, shares in coach, bus and train operator National Express Group edged 20 lower at 1,049 following a trading update from the company, which Panmure Gordon said was disappointing as it gave no indication why the company has been unsuccessful in winning rail franchises.
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Posted by john on June 30th, 2007 — in Nexium Top News
So I have this back spasm, and I am in excruciating pain, unable to walk, barely able to crawl to the phone to call for help. I have a choice to make.
Option #1: I can call a friend to take me to the hospital emergency room, where I may wait hours to see a doctor.
After looking me over and asking a few questions, he/she will prescribe pain medication and muscle relaxants.
This commonly used prescription drug is produced by a corporation whose main goal is not my health, but to make money for itself.
This becomes evident when I look at the warnings from health.canoe.ca:
This medication should not be taken by anyone who:
Is allergic to methocarbamol, ASA, codeine or any ingredients of the medication (including tartrazine dye); has an active stomach ulcer or duodenal ulcer; has had a bronchospastic reaction (severe asthma-type reaction), generalized hives, severe running and itching nose, or shock brought on by ASA or other nonsteroidal anti-inflammatory drugs (NSAIDs, e.
g., ibuprofen, naproxen), the list goes on.
Side effects may include: dizziness; lightheadedness, or feeling faint; drowsiness, heartburn or indigestion; nausea or vomiting; stomach pain (mild).
Less common or rare: abdominal or stomach cramps or pain; blurred or double-vision or other changes in vision; clumsiness or unsteadiness; constipation; diarrhea; dryness of mouth; false sense of well-being; frequent urge to urinate; general feeling of discomfort or illness; headache; hiccups; loss of appetite; muscle weakness; nervousness or restlessness; nightmares or unusual dreams; trouble sleeping.
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Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention…
Option #2: I can call a friend to bring me some of her homemade organic cannabis tincture.
She will apply it to my back and the spasm will be gone in minutes. Cannabis is anti-spasmotic, analgesic and anti-inflammatory.
I will get a good night’s rest, reapply the tincture whenever the pain comes back, and take it easy for a few days.
There are no negative side effects.
This plant has been used for 5,000 years to cure pain and spasm, among many other ailments.
You used to be able to buy it by the pound in the grocery store.
In fact, when it was outlawed in 1937, the American Medical Association was in an uproar because almost half of what every doctor carried in his little black bag was a derivative of marijuana.
Of course, owning the cannabis tincture today would be illegal so… Option #3: Maybe I’ll just lie here on the floor and wonder why we are arresting the wrong people.
Seems to me that the prescription drug fits the definition of a poison and a danger to society, while the only problem with cannabis is that it is illegal.
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Posted by john on June 25th, 2007 — in Nexium Top News
Last year alone, Americans spent $942 million dollars on over-the-counter antacids, and a whopping 13.6 billion dollars on prescription acid suppressants. So how can we manage our acid reflux disease, and other similar symptoms? Are antacids always a good idea? Dr. Leo Galland, a medical advisor to the consumer newsletter “Bottom Line Personal” and author of the book “The Fat-Resistance Diet,” offers tips and natural remedies that could make us stop popping those pills.
Millions of Americans take drugs to relieve excess stomach acid. In fact, acid-suppressing drugs are among the most frequently prescribed medications in the US. They fall into two categories:
* Proton-pump inhibitors like Prilosec, Prevacid, Nexium, Aciphex and Protonix. What they do is inhibit the enzymes that transport acid from the acid-secreting cells into the lining of the stomach.
* H2 blockers like Zantac, Pepcid, Axid and Tagamet. H2 blockers inhibit the activity of histamine in the stomach. Histamine stimulates stomach cells to secrete more acid.
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Although these drugs can be effective at relieving symptoms like heartburn and abdominal pain, they may have serious long-term side effects. Regular use of acid-suppressing drugs is associated with increased risk of hip fractures, probably because of impaired calcium absorption. Taking acid-suppressors also increases your risk of acquiring a food-borne intestinal infection or experiencing the overgrowth of bacteria in the stomach and small intestine. Overgrowth of bacteria in the stomach probably explains some other risks associated with regular use of acid suppressors including pneumonia, stomach cancer and vitamin B12 deficiency.
Gastroesophageal reflux vs. gastritis
Acid suppressing therapy is primarily used to treat two kinds of problems — gastroesophageal reflux (GERD) and gastritis (inflammation of the stomach lining). In gastroesophageal reflux, contents of the stomach flow backward up the esophagus and may reach all the way to the mouth. Symptoms include heartburn, chest pain, regurgitation of food, sore throat, hoarse voice and cough. Although acid suppressors are commonly prescribed, GERD is not caused by excess production of acid. It is caused by failure of the valve that separates the esophagus from the stomach (the LES or lower esophageal sphincter valve).
The good news is that there are natural remedies for these GERD problems that work even better than drugs and without the side effects:
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* Don’t stuff yourself. When you eat a lot at one time it causes stomach distension, which triggers relaxation of the LES.
* Avoid high fat foods such as fried foods and cream sauces. These weaken the LES.
* Don’t smoke. This also weakens the LES.
* Don’t eat for three hours before lying down. When you’re upright, gravity works with you.
* Maintain a normal weight. Being overweight increases your risk of GERD.
* Don’t eat just before strenuous exercise. Strenuous exercise increases the tendency to get GERD.
* Avoid foods that you know cause you discomfort until you’re better. So-called “acid” foods, like oranges and tomatoes, do not cause GERD, but they may irritate an already inflamed esophagus
These simple steps prevent symptoms of GERD in the majority of people and may allow you to avoid the use of acid-suppressing drugs. If not, try:
* Calcium. Calcium tightens the LES valve. This is not an antacid effect. In fact, the best type of calcium, because it is the most soluble, is calcium citrate, which is itself mildly acidic. The most effective preparation is calcium citrate powder. Take 250 mg, dissolved in water, after every meal and at bedtime (for a total daily dose of 1,000 mg). Swallowing calcium pills does not prevent reflux because the calcium is not instantly dissolved.
* Digestive enzymes. These appear to work by decreasing distension of the stomach. The enzymes should be acid-resistant, so they work in the stomach itself, not in the small intestine. A powdered enzyme preparation (1/2 teaspoon) can be mixed together with the calcium powder above and taken after each meal. Digestive enzymes are available in health food stores and pharmacies.
Gastritis
The leading cause of gastritis (inflamed stomach lining) in the U.S. is the regular use of aspirin and anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve). Other causes include cigarette smoking, regular use of alcohol and the irritant effects of other medications, especially antibiotics.
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Posted by john on June 23rd, 2007 — in Nexium Top News
CHRISTOPHER–A Franklin county woman is battling a rare liver disease that could one day require her to undergo a liver transplant.
Ginger Farmer-Sims enjoys spending time with her family. She watches as her daughter, Joanna, plays with her cousins in the front yard.
But because she’s been ill, Ginger isn’t able to play with the children.
“I have two children. It’s very difficult to play with them. I’m tired a lot. I sleep a great deal. ”
Ginger has non alcoholic steatohepatitis or NASH. She was diagnosed in May after doctors here sent samples of her liver to the Mayo clinic.
“It’s very rare. Two to five percent of Americans are afflicted with it. It causes irreversible liver inflammation and the damage can lead to liver cancer.”
Right now, there is no treatment for NASH.
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Doctors are trying to stabilize the condition with a laundry list of medications, including hydrocodone for the pain, prednisone for the inflammation of the liver, and insulin to balance her blood sugar.
Despite having insurance, and a medical card, not everything Ginger needs is covered.
“Two of my medications, the insurance won’t pay for. One of those is Nexium, and it’s a little over $200 a month. The other one is right at $200 a month.”
That’s where you can help.
A fried chicken is planned for Sunday in Christopher from 11:30 until 3:30 at the Hampton Building.
Meals are eight dollars per person. Money raised will help pay Ginger’s medical expenses, rent, and utilities.
Because she is so sick, Ginger had to quit her job as a surgical technician at Good Samaritan Hospital in Mt. Vernon.
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Posted by john on June 17th, 2007 — in Nexium Top News
My sister has a calcium deficiency. She takes two capsules of Nexium daily. Could this be a factor in her deficiency?
A: Theoretically, Nexium could be a factor.
Nexium (esomeprazole) is prescribed to reduce stomach acid. The absorption of some calcium supplements, particularly calcium carbonate, may be impaired when stomach acid is reduced.
You didn’t say whether your sister was taking a calcium supplement. If she’s taking calcium carbonate, she might wish to switch to a calcium citrate product, which may be less affected by reduced stomach acid. See the following topic for more.
Q: I found information on the Internet that states it is the elemental calcium that is important, and that these amounts vary with the product. How does one know the amount of elemental calcium in a supplement?
A: “Elemental” calcium refers to just the calcium portion of calcium compounds.
Two of the most commonly used compounds in calcium supplements are calcium carbonate and calcium citrate, which contain about 40 percent and 21 percent of elemental calcium, respectively. To get 1,200 mg. of elemental calcium, for instance, you’d need to take 3,000 mg. of calcium carbonate or 5,700 mg. of calcium citrate.
Other calcium tips:
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_You can fulfill part, and perhaps all, of your daily calcium needs from foods. Consider the “Rule of 300s”: You’ll get about 300 mg of elemental calcium from an 8-ounce glass of milk, cup of cottage cheese, bowl of ice cream or yogurt, or one-ounce serving of cheese. For instance, four glasses of skim or nonfat milk provide 1,200 mg of elemental calcium.
_The body can absorb only so much calcium at a time. Absorption of elemental calcium from supplements is most efficient in doses of 500 mg or less, spread throughout the day as needed.
_It’s generally recommended that calcium supplements be taken with meals. Meals increase stomach acid secretion, which may enhance calcium absorption. Be aware, however, that certain dietary fiber constituents can bind to calcium and impair its absorption. These include phytates, which are present in most cereals, wheat bran, unleavened bread, nuts and legumes (such as beans), as well as soy foods. Others are oxalic acid (found in rhubarb and spinach) and uronic acid (a common plant fiber component).
_Take calcium supplements two hours apart from the times you drink milk or ingest other dairy foods. Dairy products are high in phosphorus, which can bind to the calcium in supplements and inhibit its absorption.
_Adequate vitamin D is required for proper calcium absorption. Foods providing vitamin D include fish liver oils, eggs, butter and fortified milk and cereals. Look for supplement products with D3 (cholecalciferol), the most potent form. And remember that the body synthesizes D3 when exposed to the sun’s UV radiation.
_Current daily upper intake levels are 2,500 mg. for calcium and 2,000 IU for vitamin D. Stay under these amounts and count both dietary sources and supplements in your total intake.
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Posted by john on June 13th, 2007 — in Nexium Top News
“Acid reflux popularly known as heartburn is a disease that is very dangerous to man and can lead to cancer of the oesophagus.” We hear and see all these everyday in the ads which want us to buy one or two of their products to cure heartburn. Well, it is possible that all these effects of heartburn can be highly overrated and can be marketing strategies devised to just sell us their drugs and medicines. This is because even doctors do not agree on the causes, treatment methods, and long-term effects of heartburn.
That said, heartburn is the painful, burning, pepper-like sensation felt in the chest as a result of acid reflux or gastroesophageal reflex disease GERD( Pretty jaw-breaking. eh?). It can also be a feeling of pressure in the chest which is the reason it is sometimes mistaken as heart attack symptoms. Acid reflux happens when the acidic contents of the stomach move back into the oesophagus as a result of the weakening of the stomach muscles; and since the oesophagus unlike the stomach, does not have protective covering, the acid burns the oesophagus.
In the light of this then, what can be done to reduce the effects or probably cure it completely?
Quite a number of over the counter non-prescription drugs can help reduce the effects of mild to moderate heartburn/ acid reflux. These prescriptions include antacids which neutralize the gastric acids. These include well-known prescription such as Tums and Rolaids, Mist- Mag, Mist suspension. These drugs contain magnesium trisilicate.
Another option of treatment could be the H2 receptor antagonists. These reduce the production of stomach acids. Some examples of these are Tagamet HB, Pepcid AC, and Axid AR et.c. Pepcid complete has been found to a lot more effective because it contains both an H2 receptor antagonist and antacid. Therefore, it is deemed the best treatment as it is better than having at antacid alone, or an H2 receptor alone.
Prescription drugs that can help ameliorate the effect and treat reflux acid are proton-pump inhibitors. These include Prilosec, Aciphex, Nexium, Protonic, and Prevacid. Although all of them are effective in the treatment of acid reflux, Nexium has been found to heal oesophagus sores quicker.
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You can also consider homeopathic remedies and treatments. When combined with this, acid reflux can be treated with less reliance on OTC or prescription drugs. These might just provide the needed answers as combining one or two remedies may cure heartburn faster than if they were used alone.
The natural and herbal treatments that are likely to help in the reduction of heartburn are Deglycyrrhizinated licorice popularly called DGL, which can bring fast relief and heal damaged oesophageal lining. The Aloe Vera juice too also acts quickly to bring relief. And for people who have chronic acid reflux disease, Rice bran oil (Gamma-oryzanol), choline, pantothenic acid and thiamin are useful in the faster cure and healing. Please note that these natural remedies provide more of short term relief than long term.
Quite a number of people opt for these homeopathic remedies because they less expensive and reduce that chance of relying on just a one solution which can be drastic if the solution goes out of circulation. The beauty of natural solutions is that it not only treats the effects, it also treats the causes and can be combined with both over the counter and prescription drugs.
Research on whether acid reflux causes cancer are still being conducted as some studies show that chronic acid reflux increased the chances of oesophageal cancer by as much as eight times. Another one states that the risk of having cancer from acid reflux is not as high as was once thought even though chronic heartburn can result in Barrett’s’ oesophagus which has a high chance of resulting into cancer for quite a few people; not most
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Posted by john on June 10th, 2007 — in Nexium Top News
Exercise may keep you healthy and strong, but most people don’t know that it can also cause heartburn. The good news is that exercise-induced heartburn can be controlled for heartburn sufferers to help them continue an active lifestyle.
The Link Between Exercise and Heartburn
Researchers believe that certain exercises may increase abdominal pressure and push stomach acid into the esophagus, contributing to heartburn symptoms. Below are some tips from the National Heartburn Alliance to avoid heartburn during exercise:
• Avoid vigorous exercises. A bouncing type of exercise, such as jogging, can increase your chances of suffering from acid reflux.
• Pass up protein and fatty snacks. Food that is consumed less than two hours before exercising makes a huge impact on the occurrence of heartburn. Preworkout meals should be high in carbohydrates and low in fat and protein.
• Limit types of foods. Certain foods and beverages are more likely to cause heartburn than others. Moderate your intake of citrus fruits and juices, chocolate, onions, peppermint, spearmint, fatty or spicy foods and caffeinated or carbonated beverages.
• Time your meals. Exercising on a full stomach is not advisable, largely because it increases intra-abdominal pressure, which may contribute to heartburn. Wait at least two hours after a meal before exercising.
• Control quantity. Decrease portion sizes when eating prior to exercise. Reflux is more likely to occur when there is a lot of food in the stomach.
• Drink plenty of water before and during exercise. Water aids in digestion and also prevents dehydration.
• Talk to your health care professional. Confirm what types of exercises cause the least amount of discomfort for you and what you can do to ease the heartburn if it reoccurs. Your doctor can advise you and help you understand differences between available treatment options.
• Use the appropriate medication to help avoid future heartburn. In addition to speaking to your doctor, choosing the correct heartburn medication is an important step in preventing exercise-induced heartburn. Treatment options are available, including antacids (e.g., Tums®), H2 blockers (e.g., Zantac®) and proton pump inhibitors (e.g., Prilosec OTC®). Speak to your doctor about which is best for you.
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“With the proper treatment, active individuals can continue their regular exercise regimen without worrying about the return of heartburn,” says Dr. Janet Engle, a Clinical Professor at the College of Pharmacy at the University of Illinois at Chicago. “If heartburn induced by exercise continues to be a problem, you should talk to your doctor about the treatment option that is best for you.”
The Many Faces of Heartburn
For the more than 60 million people who suffer from heartburn each month in the U.S., understanding and finding treatment options can be difficult. The key to treating exercise-induced heartburn is to understand what type you have.
Heartburn is a condition caused by stomach acid flowing up into the esophagus; however, contrary to popular belief, there are different types of heartburn:
• Episodic or occasional heartburn is characterized by infrequent bouts of heartburn that are usually manageable or predictable in the short term.
• Frequent heartburn (FHB) occurs two or more days per week. Frequent heartburn sufferers may also be those who medicate heartburn symptoms more than two days per week. People with FHB might also find themselves using multiple over-the-counter (OTC) medications more than two days a week for relief.
• Severe or chronic heartburn occurs more than two days per week and persists while taking appropriate medications, despite dietary and lifestyle changes. Sufferers with severe heartburn should speak to a health care professional.
“Understanding these various types of heartburn is key to knowing how to choose the most appropriate medicine,” says Dr. Engle. “Just as not all heartburn is the same, not all medicine is the same.”
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Posted by john on June 5th, 2007 — in Nexium Top News
AstraZeneca (NYSE: AZN) will present several studies today regarding pediatric patients with gastroesophageal reflux disease (GERD) during oral and poster sessions at the annual Digestive Disease Week meeting held at the Washington Convention Center.
The studies being presented further support AstraZeneca’s commitment to research in the area of gastrointestinal health among the pediatric population. NEXIUM (esomeprazole magnesium) received approval in April 2006 for the short-term treatment (up to 8 weeks) of GERD in adolescent patients aged 12 to 17. The approval is supported by extrapolation of results from adequate and well-controlled studies that supported the approval of NEXIUM for adults, and safety and pharmacokinetic studies performed in adolescent patients. The safety and effectiveness of NEXIUM for the treatment of symptomatic GERD in patients less than 12 years of age and for other pediatric uses have not been established.
The exact prevalence of GERD in children is unknown. However, GERD can lead to potentially serious complications like failure to thrive and erosive esophagitis in children. There are very few studies in the medical literature reporting the frequency of GERD symptoms in children. One such study, a practice-based survey looked at the prevalence of GERD symptoms in 3-17 year old children. The study included 566 parents of otherwise healthy 3-9 year old children and revealed that symptoms of GERD (heartburn, epigastric pain and regurgitation) were reported weekly in 2-8%, which is not that uncommon.
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“GERD, which can potentially lead to more serious conditions, not only impacts adults but it is also common in childhood,” said Marta Illueca, MD, F.A.A.P., Director, Clinical Research, GI Respiratory, AstraZeneca. “With patient health being our priority, one of our objectives is to better understand pediatric GERD and how to treat the younger population affected by this chronic but treatable disease.”
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Posted by john on June 2nd, 2007 — in Nexium Top News
A New York district court has ruled that Mylan Laboratories’ generic version of AstraZeneca’s heartburn drug, Prilosec, does not infringe on the brand maker’s patents.
Canonsburg, Pa.-based Mylan has been selling the product, omeprazole delayed-release capsules, for nearly four years despite the lawsuit.
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“Our decision to launch at risk has resulted in significant savings to consumers around the country who have had access to a lower cost generic version of this important product while this lawsuit continued,” Mylan chief Robert J. Coury said. “We are pleased to have prevailed in the litigation.”
At the same time, the court ruled that omeprazole products from two other companies — Apotex in Canada and Impax Laboratories in California — do infringe on London-based AstraZeneca’s patents.
AstraZeneca also makes a newer ulcer treatment, Nexium.
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Posted by john on May 29th, 2007 — in Nexium Top News
The diagnostic procedure is noninvasive and painless.
It’s chemical warfare in the digestive system for the estimated 7 million Americans who suffer from a condition known as GERD (gastro-esophageal reflux disorder).
For people such as James McMahon, their acid reflux was so frequent and severe that serious health consequences were possible.
But it’s not just a health issue. It’s a quality-of-life issue.
“I had GERD for maybe two, three or four years,” says McMahon, 70, of Toms River. “The symptoms were almost constant, very uncomfortable and very bothersome.”
Whatever treatment he was receiving did not seem to bring much relief.
A relatively new diagnostic tool is being used at hospitals such as Community Medical Center in Toms River to help people like McMahon, something called the Bravo pH Monitoring System.
“Gastro esophageal reflux disorder or GERD occurs,” says Dr. Eric Eschinger, a gastroenterologist on staff at Community Medical Center, “when the lower esophageal sphincter — a specialized band of muscle that acts as a sort of valve between the esophagus and stomach — fails to close properly and allows food particles and stomach acids to splash back up, or reflux, into the esophagus.”
That weakened muscle produces chronic heartburn and acid reflux, the most common symptoms of GERD, which may also lead to belching, difficult or painful swallowing, laryngitis, chest pain, inflammation of the gums, erosion of teeth enamel, a sour taste in the mouth or bad breath.
According to Eschinger, periodic heartburn that occurs just after a meal or less than once a week is relatively common and can usually be resolved with an over-the-counter antacid.
If heartburn begins to affect the quality of your life, it’s time to seek medical treatment.
“Heartburn that occurs more frequently, becomes severe, occurs at night or wakes a person from sleep may be a sign of GERD,” he says, and should be evaluated by a physician. If GERD goes undiagnosed and is left untreated, it can cause erosions or ulcers in the lining of the esophagus, strictures — a narrowing of the esophagus — or a potentially pre-cancerous disease that involves a cellular change in the lining of the esophagus known as Barrett’s esophagus.
And GERD can mess with more than the digestive system. When the base of the esophagus is weak, patients also risk dislodging small particles of food or stomach acid into the lungs, which can result in coughing, wheezing, asthma, chronic laryngitis and recurrent pneumonia.
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Measuring the frequency of gastroesophageal reflux and acid levels in the esophagus is key to diagnosing GERD and developing a successful treatment plan for patients.
“Traditionally,” Eschinger says, “these measurements were gathered by placing a catheter, connected to a monitoring device, down the patient’s nose and into the esophagus for a 24-hour period.”
It’s not the most comfortable test in the world.
“I’ve had patients call me up at night and say, “I’m pulling the catheter out now. I can’t take it.’ It was that uncomfortable.”
The Bravo pH monitoring system doesn’t use a catheter.
It allows patients to go about their normal daily routines throughout the test period after a 20-minute procedure in which a Bravo pH capsule — the size of a gel cap — is placed down the throat using an endoscope. The capsule, which contains a radiotelemetry pH sensor — is temporarily attached or “deployed,” in the words of Eschinger, to the wall of the lower esophagus and the endoscope is removed.
The tiny capsule remains in the esophagus, where it measures gastro-esophageal acid levels every six seconds and transmits the pH data via radio frequency to a pager-size receiver worn by the patient. The measurements received by the pager are uploaded to a computer, which analyzes the data and provides a complete report for the most accurate diagnosis and treatment planning.
In addition to the computerized data, some patients also are asked to fill out a diary of symptoms and that data is superimposed over the pH-level information to provide a more complete picture.
There are no worries, either, that a patient is going to have an electronic bug stuck in his or her throat forever.
“Several days after the exam is complete, normal swallowing and the passage of food cause the Bravo gel cap to naturally slough off the esophagus and pass through the patient’s digestive tract,” Eschinger says.
But while it’s there, he adds, it can extend the monitoring up to 48 hours, which gives a more complete picture of when the acid is erupting. This test helps those with atypical symptoms and those who still have pain after other treatments have not proven helpful.
“The procedure was painless,” says McMahon. “I didn’t even know the device was inside of me. It really helped in that the doctors were able to adjust my medication, and I feel a lot better these days.”
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